临床儿科杂志 ›› 2022, Vol. 40 ›› Issue (1): 8-.doi: 10.12372/jcp.2022.21e1628

• 专家笔谈 • 上一篇    下一篇

造血干细胞移植后出血性膀胱炎的诊疗

何云燕   

  1. 广西医科大学第一附属医院儿科(广西南宁 530021)
  • 出版日期:2022-01-15 发布日期:2022-01-11

Diagnosis and treatment of hemorrhagic cystitis after hematopoietic stem cell transplantation

HE Yunyan   

  1. The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
  • Online:2022-01-15 Published:2022-01-11

摘要: 出血性膀胱炎(HC)是异基因造血干细胞移植的常见并发症之一,是移植防治的重点,文章就HC病因、 发病机制和防治现状作一介绍。HC的发生常与移植前大剂量放化疗毒性,药物代谢酶基因多态性,病毒感染,移植物 抗宿主病,患者的年龄、性别,供者类型和移植方式等相关。根据相关病史、典型临床表现和必要的辅助检查可以诊断。 有效的预防措施是充分水化碱化尿液及利尿剂和美司钠的应用。治疗主要包括抗病毒治疗、免疫治疗、膀胱冲洗、膀 胱灌注、高压氧治疗和手术治疗等。

关键词: 出血性膀胱炎; 异基因造血干细胞移植; BK病毒; 儿童

Abstract: Hemorrhagic cystitis (HC) is one of the common complications of allogeneic hematopoietic stem cell transplantation, which is the key point of transplantation prevention and treatment. This article introduces the etiology, pathogenesis, prevention and treatment of HC. The occurrence of HC is often related to the toxicity of high-dose radiotherapy and chemotherapy before transplantation, gene polymorphism of drug metabolism enzyme, viral infection, graft-versus-host disease, patient age, sex, donor type and transplantation method. Diagnosis of HC is not difficult, based on the history, typical clinical manifestations, and necessary auxiliary tests. Effective preventive measures are adequate hydration and alkalization of urine, diuresis and the application of Mesna. The treatment mainly includes antiviral therapy, immunotherapy, bladder irrigation, bladder perfusion, hyperbaric oxygen therapy and surgical treatment.

Key words: hemorrhagic cystitis; allogeneic hematopoietic stem cell transplantation; BK virus; child